ABP Society Membership Application

ANTIGUA & BARBUDA PROGRESSIVE SOCIETY, INC.

501(c)(3) Non-profit Organization
"HELPING COMMUNITIES THRIVE AND GROW"
MEMBERSHIP APPLICATION FORM
Date*

MonthDayYear
Date
To: The officers and members of the Antigua and Barbuda Progressive Society, Inc., I the undersigned hereby make application to your honorable body to become a member of your society. If accepted, I promise to abide by the Society’s By-Laws.
Name*

First NameLast Name
Spouse/Partner:
E-mail*
Address*

Street Address

Apt./Suite #

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Country of Birth*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Occupation
Membership Fee (valid for the current calendar only and can be renewed annually)*

$180 - annually$15 - monthly
A payment request for the membership fee will be sent to your e-mail address upon receipt of your application. Payment can be rendered by using a Zelle account.
Should be Empty:

ANTIGUA & BARBUDA PROGRESSIVE SOCIETY, INC.